骨髓病理检查对侵袭性NK细胞白血病的诊断价值

目的 探讨侵袭性NK细胞白血病（ANKL）患者骨髓病理活检的早期诊断价值.方法 回顾分析10例ANKL患者的临床资料、骨髓病理和免疫组化及原位杂交的结果.结果 ANKL患者骨髓组织常显示增生活跃,4例极度活跃.可见灶状和簇状分布的异型瘤细胞,呈浸润性生长.瘤细胞胞体中等大小,胞质少,核形态稍不规则,染色质较细致、核仁不明显,核分裂易见.骨髓的病理切片中噬血组织细胞不同程度的增多是本病的重要组织学特征.瘤细胞均不同程度地表达CD2、CD38、CD7、CD56、,TIA-1,所有病例EBER原位杂交阳性.结论 骨髓病理活检及免疫组化在ANKL的早期诊断中具有重要的价值.

The clinical value of bone marrow biopsy in diagnosing aggressive NK cell leukaemia

Objective To explore the value of bone marrow biopsy ( BMB) in early diagnosis of aggressive NK cell leukaemia( ANKL). Methods The clinical data of ten cases with ANKL were retrospectively analyzed,morphology, immunophenotype and hybridization in situ of bone marrow were analyzed. Results In all cases, BMB showed hypercellular, with 4 cases markedly hypercellular. Atypical neoplastic cells demonstrated focal and fascicle growth pattern and were composed of median-sized cells with a few cytoplasm, slightly irregular nuclei, fine chromatin, indistinct nucleoli and some mitotic counting. Characteristic histocytes with haemophagocytosis were observed in the bone marrow slides. The neoplastic cells were positive for CD2、CD3e、CD7、CD56、TIA-1. EBER was found positive in all cases. Conclusion Bone marrow biopsy and immunochemistry were essential and reliable diagnostic tool in early diagnosis of ANKL.